Apheresis‐induced platelet activation:comparison of three types of cell separators

Hagberg, Inger Anne; Akkök, C. A.; Lyberg, Torstein; Kjeldsen‐Kragh, Jens

doi:10.1046/j.1537-2995.2000.40020182.x

Cited by 80 publications

(107 citation statements)

References 66 publications

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“…This increase appeared to be caused by the isolation of the component itself from the activation of contaminating platelets, either by the tubing or the isolation technique, because the Cobe Spectra (Gambro BCT) machines are reported to cause activation of a small amount of platelets during collection. 32 When platelet contamination is decreased by prestorage leukoreduction with a filter that removes platelets, the generation of sCD40L is decreased. These results are congruous with estimates that 95% of all human sCD40L is platelet derived, 33 both in apheresis procedures and in the collection of whole blood for separation into components.…”

Section: Discussionmentioning

confidence: 99%

Soluble CD40 ligand accumulates in stored blood components, primes neutrophils through CD40, and is a potential cofactor in the development of transfusion-related acute lung injury

Khan¹,

Kelher

Heal

et al. 2006

Blood

372

418

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Transfusion-related acute lung injury (TRALI) is a form of posttransfusion acute pulmonary insufficiency that has been linked to the infusion of biologic response modifiers (BRMs), including antileukocyte antibodies and lipids. Soluble CD40 ligand (sCD40L) is a platelet-derived proinflammatory mediator that accumulates during platelet storage. We hypothesized that human polymorphonuclear leukocytes (PMNs) express CD40, CD40 ligation rapidly primes PMNs, and sCD40L induces PMN-mediated cytotoxicity of human pulmonary microvascular endothelial cells (HMVECs). Levels of sCD40Lwere measured in blood components and in platelet concentrates (PCs) implicated in TRALI or control PCs that did not elicit a transfusion reaction. All blood components contained higher levels of sCD40L than fresh plasma, with apheresis PCs evidencing the highest concentration of sCD40L followed by PCs from whole blood, whole blood, and packed red blood cells (PRBCs). PCs implicated in TRALI reactions contained significantly higher sCD40L levels than control PCs. PMNs express functional CD40 on the plasma membrane, and recombinant sCD40L (10 ng/mL-1 g/mL) rapidly (5 minutes) primed the PMN oxidase. Soluble CD40L promoted PMN-mediated cytotoxicity of HMVECs as the second event in a 2-event in vitro model of TRALI. We concluded that sCD40L, which accumulates during blood component storage, has the capacity to activate adherent PMNs, causing endothelial damage and possibly TRALI in predisposed patients. IntroductionCD40 is a 48-kDa transmembrane glycoprotein and a member of the tumor necrosis factor (TNF) receptor family expressed on endothelial and epithelial cells, monocytes, and macrophages. 1 CD40 ligand (CD40L [CD154]) is a primarily platelet-derived pro-inflammatory mediator found in soluble (sCD40L) and cellassociated forms in transfused blood. 2,3 Soluble CD40L activates macrophages and elicits the production and release of multiple proinflammatory cytokines. 4 Furthermore, inhibition of the CD40-CD40L system in animal models reduces acute lung injury (ALI) caused by endotoxin (lipopolysaccharide [LPS]) or oxygen toxicity. [5][6][7] In addition, sCD40L is present in platelet concentrates and accumulates over routine 3-to 5-day storage times. 3 Polymorphonuclear leukocytes (PMNs) are critical in host defense against pathogens and exert their major microbicidal function in the tissues. 8,9 PMN priming is initiated by the attraction and adhesion of PMNs to activated vascular endothelium and continues until the pathogens are phagocytosed and destroyed. 6,[10][11][12] PMN-mediated acute lung injury (ALI) requires at least 2 separate events: endothelial activation, which includes the synthesis and release of chemokines and the increased surface expression of adhesion molecules that elicit PMN adhesion, and activation of adherent PMNs, which causes the release of their microbicidal arsenal and results in endothelial damage, capillary leak, and ALI. 10,11,[13][14][15][16] Such a 2-event model has been proposed for ALI, especially for transfusion...

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Section: Discussionmentioning

confidence: 99%

Soluble CD40 ligand accumulates in stored blood components, primes neutrophils through CD40, and is a potential cofactor in the development of transfusion-related acute lung injury

Khan¹,

Kelher

Heal

et al. 2006

Blood

372

418

View full text Add to dashboard Cite

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“…However, Cardigan et al (21) reported that the reactivity of platelets to stimuli such as physiological agonists, rather than the glycoprotein expression without agonists, might be a better predictor of in vivo platelet transfusion efficacy. Recently, several studies have reported on CD62P expression in agonist-stimulated platelets for the evaluation of platelet function in platelet products (8)(9)(10)(11)(12)(13)(14)(15). However, agonist-induced expression of CD62P by flow cytometry analysis is not easy to use routinely.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, agonist-induced expression of CD62P, or other markers, has been investigated in several studies to determine platelet function in platelet products (8)(9)(10)(11)(12)(13)(14)(15), because the functional reactivity of platelets could be used to predict platelet transfusion efficacy. However, agonist-induced expression of CD62P by flow cytometry analysis has some disadvantages, including the expense of the equipment and reagents, and the difficulty of the associated procedures.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of delta value of platelet parameters on ADVIA 120 for the functional reactivity of stored platelets

Park

Lim

Cho³

2010

Clinical Laboratory Analysis

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An agonist-induced expression of CD62P by flow cytometry analysis for evaluating platelet functional reactivity has some disadvantages. We investigated the usefulness of platelet parameters by ADVIA 120 to predict an agonist-induced expression of CD62P in stored platelets. The CD62P expression by flow cytometry and the platelet parameters by ADVIA 120 were studied in samples from 27 platelet pheresis products. Delta (D) values were calculated as the degree of change of the platelet parameters studied with or without adenosine 5 0 -diphosphate sodium (ADP) stimulation. The CD62P expression of the ADP-activated platelets were correlated with the Dplatelet count (r 5 0.517) in the short-term storage group (within 10 hr from preparation), with the platelet component distribution width (PCDW) without ADP (r 5 À0.744) and the DPCDW (r 5 À0.755) in the long-term storage group (after 10 hr from preparation). Therefore, the delta values of platelet parameters on ADVIA 120 analysis in platelets between with and without ADP stimulation could be useful as a simple predictor for the functional reactivity of stored platelets.

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“…As calculated from TSD 2.5 (table 4), only TA allowed for additional units per machine per 8-hour working day compared to our current equipment. Another drawback of AM procedures consisted in higher PLT activation, also reported by Hagberg et al [38]. While PLTs harvested with MCS+, TA, TV4, or SPC were transferred intermittently or continuously to large PLT storage containers outside the centrifuge, AM PLTs were stored as 'dry PLTs' in a small bag within the centrifuge during the entire separation procedure, resulting in intimate contact with each other and the plastic material.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Crossover Trial Comparing Performance and in vitro Platelet Quality of Three New Apheresis Devices with Current Equipment

Picker¹,

Radojska²,

Gathof³

2006

Transfus Med Hemother

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Background: To improve productivity of automated platelet (PLT) collection, the industry has introduced new instruments or modifications to existing equipment. Materials and Methods: Data obtained from 8 regular PLT apheresis donors randomized to double- (DDC) or triple-dose PLT collection (TDC) with the BAXTER Amicus (AM), the HAEMONETICS MCS Plus (MCS+), and the GAMBRO Trima Accel (TA) were evaluated focusing on duration, citrate infusion and product quality, and statistically compared to data obtained from the same donors during DDC on our current equipment (GAMBRO Trima V4 (TV4) and Spectra LRS-Turbo V7 (SPC)). Results: All units were sufficiently leukoreduced to below 1 × 106 white blood cells (WBCs). Apart from statistically significant lower pH values and higher CD62P expression observed with AM units, no differences in in vitro function were noted during storage. Compared to our current equipment, the new devices had advantages for whole blood processed, and, except for MCS+, for needle time, collection volume, collection rate, and collection efficiency. PLT yield and processing time were equivalent, except for TA which was the fastest machine. MCS+ was the slowest device owing to statistically significant lower draw and collection rates which were, however, compensated by fewer citrate reactions due to only moderate citrate infusion rates. Conclusion: Despite equal or better efficiencies, collection procedures with the new devices did not automatically increase the number of units per day, particularly if quick donation was counteracted by long overall performance (AM). TA was the fastest and hence offered the highest potential to optimize productivity. MCS+ showed better donor comfort, as reflected by lower draw and citrate infusion rates, but was also the slowest.

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Apheresis‐induced platelet activation:comparison of three types of cell separators

Abstract: After 90 minutes' processing time, platelets obtained with the Amicus cell separator were significantly more activated than platelets harvested with the Spectra and the MCS+.

Cited by 80 publications

References 66 publications

Soluble CD40 ligand accumulates in stored blood components, primes neutrophils through CD40, and is a potential cofactor in the development of transfusion-related acute lung injury

Soluble CD40 ligand accumulates in stored blood components, primes neutrophils through CD40, and is a potential cofactor in the development of transfusion-related acute lung injury

Usefulness of delta value of platelet parameters on ADVIA 120 for the functional reactivity of stored platelets

A Prospective Crossover Trial Comparing Performance and in vitro Platelet Quality of Three New Apheresis Devices with Current Equipment

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